[Clinical application of pocks embedding in duodenal stump closure after radical gastrectomy for gastric carcinoma].

Objective: To explore the clinical effect of pockets embedding in duodenal stump closure after gastrectomy for gastric cancer.

Methods: A total of 2034 patients undergoing gastrectomy from January 1995 to December 2009 at our hospital were reviewed. Among them, Group A (n = 465) underwent pockets embedding for duodenal stump, Group B (n = 835) line-cutting stapler and hand-sewing while Group C (n = 734) double layer hand-sewing. The operation cost, processing time of duodenal stump, recent post-operative complications (within 1 month), blood loss volume and post-operative recovery status were compared between 3 groups.

Results: No patient died of operation. Ninety-five cases (4.7%) suffered recent post-operative complications. The most frequent complications included wound infection (36 cases, 37.9%), intra-abdominal hemorrhage (18 cases, 18.9%) and anastomotic leakage (14 cases, 14.7%). There was no significant difference in intra-abdominal bleeding, anastomotic leakage, abdominal infection, wound infection or duodenal stump leakage among 3 groups. There was no duodenal stump leakage in Group A. The difference was apparent in comparisons with Groups B (6 cases, 0.72%) and C (5 cases, 0.68%). The operation costs of Groups A [(9902 ± 312) RMB] and C [(9896 ± 281) RMB] were significantly lower than that of Group B [(13 129 ± 237) RMB, P = 0.0001]. And there was no difference between Groups A and C. The processing time of duodenal stump in Groups A [(7.1 ± 0.9) min] and B [(7.6 ± 0.8) min] were lower than that of Group C [ (11.5 ± 1.4) min, P = 0.0001]. And there was no difference between Groups A and B. There was no significant difference in blood loss volume or post-operative recovery status among 3 groups.

Conclusion: The post-gastrotomic closure of duodenal stump with pockets embedding for gastric cancer has a short operation time, a low operation cost and a low rate of duodenal stump leakage. It is a simple, prompt, promising and safe surgical procedure for gastric neoplasms.